The Unmet Mental Health Needs of adolescents living With HIV in Eastern Tanzania: Experiences of healthcare providers, adolescents, and caregivers

Abstract Background Adolescents living with the Human Immunodeficiency Virus (ALWHIV) are at greater risk for depression than their HIV-negative counterparts and may not receive adequate mental health care. In Tanzania, there are no available data on the need for mental health services, particularly interventions for Depression in ALWHIV. Therefore, this study aimed to explore subjective experiences and unmet mental health needs of ALWHIV in Dar es salaam, Tanzania. Methods A phenomenological qualitative study design was used. Forty-five in-depth interviews and consultative meetings were conducted with ALWHIV, caregivers, and healthcare providers to explore their experiences and unmet mental health needs for ALWHIV. Data from the consultative meetings with providers were triangulated to validate the obtained information with those from interviews. Data were organized and managed with the aid of NVIvo-11. The thematic analysis framework guided the analysis of data. Results High unmet mental health needs were identified because of gaps in access to mental health care and mental health knowledge among health care providers and caregivers of ALWHIV. Depressive symptoms expressed as physical, behavioral, or somatic complaints adversely affect ART adherence, academic performance, substance use, and overall quality of life in ALWHIV. HIV-Care and Treatment Centers (HIV-CTCs) did not conduct formal mental health screenings. Instead, caregivers and Health care providers (HCPs) addressed ALWHIV-related psychological symptoms with threats of death and corporal punishments. No evidence-based depression interventions existed in HIV-CTCs for observed symptoms. Conclusions This study reveals a high level of unmet mental health needs and a clear impact on the lives of ALHIV, which may have significant implications for treatment adherence. For improved health outcomes and quality of life for ALWHIV, there is an urgent need to develop effective and scalable interventions to address these mental health needs.